Provider Demographics
NPI:1114705043
Name:THORNCHERRY PHARMACY LTC
Entity Type:Organization
Organization Name:THORNCHERRY PHARMACY LTC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-413-1509
Mailing Address - Street 1:1607 AMHERST RD NE
Mailing Address - Street 2:
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44646-4183
Mailing Address - Country:US
Mailing Address - Phone:330-413-1509
Mailing Address - Fax:330-809-0188
Practice Address - Street 1:1607 AMHERST RD NE
Practice Address - Street 2:
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44646-4183
Practice Address - Country:US
Practice Address - Phone:330-413-1509
Practice Address - Fax:330-809-0188
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THORNCHERRY RX, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-09-21
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy